Apply Online

PLEASE READ ALL INSTRUCTIONS!! DO NOT use this link to apply for the current school year of 2025-2026. Instead call 478-457-2461. This link is for the 2026-2027 school year. Thank you for your interest in applying for our 2026-2027 Head Start Program. If you have already applied for services and want to update your application, please come to the ELC to complete this process.

First Name (Required)

Last Name (Required)

Suffix

Birthday (Required)

Gender

Email Address (Required)

Confirm Email Address

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

Mobile Phone (Required)

Opt In for Text Messages

Home Phone (Required)

Work Phone (Required)

Ext.

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

SSN (Required)

Race (Required)

Hispanic (Required)

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Provides Financial Support (Required)

Teen Parent (Required)

If Teen Parent, Subsidized? (Required)

Is your family experiencing homelessness?

Living Address (Required)

Address Line 2

City (Required)

State (Required)

ZIP (Required)

Click here to find a provider in your area.

Mailing Address same as Living Address

Mailing Address

Address Line 2

City

State

ZIP

Is there another parent/guardian in the family?

First Name (Required)

Last Name (Required)

Birthday (Required)

Gender (Required)

Email Address (Required)

Confirm Email Address

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

Mobile Phone (Required)

Opt In for Text Messages

Home Phone (Required)

Work Phone (Required)

Ext.

It appears that you have previously submitted an application. If you wish to apply again, please contact us by phone or in person.

SSN (Required)

Race (Required)

Hispanic (Required)

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Highest Grade Completed (Required)

Employment Status (Required)

Child's Relationship (Required)

Custody (Required)

Provides Financial Support (Required)

Teen Parent (Required)

Are there other adults in the household?

Add Another Adult

Number of Parents/Guardians (Required)

Relationship to Participant(s) (Required)

Primary Language at Home (Required)

Number in Household (Required)

Number in Family (Required)

Gross Annual Income (Required)

Is your family receiving cash benefits or other services under the Temporary Assistance for Needy Families (TANF) program? (Required)

Is your family receiving Supplemental Security Income (SSI)? (Required)

Is your family receiving services from WIC? (Required)

Is your family receiving services under the Supplemental Nutrition Assistance Program (SNAP), formerly referred to as Food Stamps? (Required)

Is at least one parent/guardian an active duty member of the United States military? (Required)

Is at least one parent/guardian a veteran of the United States military? (Required)

Add Emergency Contact

First Name (Required)

Middle Name

Last Name (Required)

Suffix

Nickname

Birthday (Required)

Gender (Required)

SSN (Required)

Race (Required)

Hispanic (Required)

Lives with Family (Required)

English Proficiency (Required)

Other Language (Required)

Other Language Proficiency (Required)

Primary Health Coverage (Required)

Other Coverage (Required)

Doctor/Medical Home (Required)

Dental Coverage Number (Required)

Dentist/Dental Home (Required)

Does your child have a disability or do you have any concerns about your child's development? (Required)

Is there anything else you want to tell us about your child?

Which program are you applying for? (Required)

Location Preference

1st Location Preference

2nd Location Preference

3rd Location Preference

- Your Address - Available Locations

Click a location on the map to see more info

Click here to find a provider in your area.

Do you want to apply now for another child in your family?

Add Another Applicant

Are there other children in the family?

Add a Sibling

Thank you for completing your application. To complete the registration process, please bring in the following documents: Certified Birth Certificate (Original Document), Social Security Card child's (Original Document), 2 Proofs of Residency (utility bill for January 2026 or December 2025), and Proof of Income (SNAP, SSI, TANF, W-2 or 3 pay stubs for the previous months). If you have any questions, please feel free to contact us at 478-457-2461.

Required information is missing, see above.

Parent/Guardian

Address

Additional Parent/Guardian

Other Adults

Family Information

Emergency Contacts

Child (Applicant)

Location Preferences

Additional Applicant

Siblings